2. Follow-Up Before Diagnosis Improved Metabolic Control

in Children with T1D

Children at increased risk of developing Type 1 diabetes and who were enrolled in longitudinal follow-up before being diagnosed with diabetes have better metabolic control when they are diagnosed, and the positive effect on HbA1c lasts for at least 5 years, according to a study published in Diabetologia.

The Diabetes Prediction in Skåne (DiPiS) study is a prospective, longitudinal study conducted in Sweden of children who are at increased risk for type 1 diabetes. The present study assessed the glycemic control during a longer period, past the period of partial remission and after diagnosis, in children who participated in the DiPiS. Participants in the DiPiS were then compared with children who were not enrolled and who are receiving equivalent diabetes care. The cohort included 129 children diagnosed with diabetes: 51 in the group that was followed (FU) and 78 who did not participate in the DiPiS (NFU). The mean age at diagnosis was 6.8±2.9 years in the FU group and 6.5±2.6 years in the NFU group.

The FU group had a higher proportion of first-degree relatives (FDRs) with diabetes (28% vs 5.6%; p = 0.001) and a higher proportion of participants with mothers born in Sweden (100% vs 89%; p = 0.02). There was no significant difference in total daily insulin use between the 2 groups (all P >0.05), and the use of insulin pumps during follow-up and the proportion of children using them did not differ between the 2 groups at any point. HbA1c levels at diagnosis were significantly lower in the FU group vs NFU (P =0.006), as well as at 1, 2, 3, 4 and 5 years after diabetes diagnosis (all p < 0.05), and was not related to FDR status. The median HbA1c during the full 5-year follow-up was also lower for the FU group (53.3 mmol/mol) vs NFU patients (57.7 mmol/mol; P =.001).

"This improved glycemic control could improve long-term outcome and reduce the risk for complications," concluded the authors.

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